When you’re considering bioidentical hormone replacement therapy (BHRT) to address perimenopause symptoms, you have a number of choices in delivery methods. You can take oral pills that you swallow or allow to dissolve under your tongue. Or you can rub creams or gels into your skin each day. For vaginal BHRT, you can use creams, gels, or suppositories.  

But if you’re a busy woman who doesn’t want to worry about self-administering your hormones every single day, there’s another option: compound manufactured bioidentical hormone pellets.

How hormone pellet therapy works

You need to schedule an office visit with your provider to have your pellet therapy placed under your skin. The pellets are tiny, about the size of a grain of rice, and they’re sterile. The doctor makes a very small incision and inserts the pellets under the skin around your hip or upper buttock. The procedure only takes a few minutes.

Over a few months, the pellets dissolve, which allows them to gradually release hormones into your bloodstream. Around the 3-to-4-month mark, you typically go back to the office to get new pellets inserted.

The compound manufactured pellets, like the ones that come from Belmar Pharmacy, can contain bioidentical hormones, like estradiol and testosterone, in the dosages prescribed by your doctor. Bioidentical hormones match the molecular structure of hormones that are made naturally by your body.

The upside of hormone pellets

There may be some significant advantages to getting your hormone therapy via pellets.

Pellets are convenient for women with busy lifestyles. You don’t have to take a daily pill or smear on creams every morning or night. And you don’t have to worry about your hormone levels waxing and waning the next day because you forgot to take your prescription. Pellets are created to support perimenopausal and menopausal symptoms with just one visit every few months.

Pellets are absorbed into the bloodstream. They’re designed to supply the body with a consistent and continuous level of hormonal support as they slowly dissolve into the bloodstream over time. Because the hormones are absorbed into the blood vessels near the pellets, hormone delivery bypasses the digestive system and liver, minimizing metabolism in the gut.

Your pellet prescription is personalized. Each woman needs different hormones and dosages to address her disruptive symptoms, whether hot flashes, brain fog, or something else, so your provider will determine the ideal combination of pellets for your needs. For example, you may need an estradiol pellet in one strength and a testosterone pellet in a different strength. Since pellets come in a variety of options, a knowledgeable hormone provider determines which combination works well for your needs. Testosterone pellets may provide ideal symptom relief, as many women benefit from boosting testosterone in addition to boosting estrogen.

Pellets have minimal side effects. With pellets, it’s not likely you’ll experience day-to-day ups and downs in your hormone levels like you may see with pills, patches, or creams. After pellets are inserted, there can be a peak rise around the first month as the hormones are released into your body.  

The downside of hormone pellets

Pellets require a minor procedure to implant them under the skin. This requires injecting a local anesthetic and making a small incision. The insertion site is covered with a bandage and may be sore for a few days. This is repeated every few months when you need new pellets.

Many practitioners don’t accept insurance for pellets. This means patients may need to pay out of pocket for pellet therapy.  

You can’t change the dose once a pellet is implanted. This is why it’s critical to see a provider who is trained in female hormones and has the experience to prescribe the proper hormones and dosages for your needs. With a skilled provider, the majority of women get the correct dosage with their first pellets, but if not, symptoms relief may not occur until the dose is adjusted with the next pellet administration.

Are pellets right for you?

Only you can decide if compounded BHRT pellets fit your lifestyle, and discussing your symptoms and concerns with your provider may help.

Many women who use pellets for their BHRT are thrilled with the benefits. They appreciate not having to think about hormone therapy for months at a time, while it quietly does its job of replenishing their hormones. And when the dose is correct, most women say they feel great relief from symptoms.

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